Assessment of ventricular function with first-pass radionuclide angiography using technetium 99m hexakis-2-methoxyisobutylisonitriIe: a European multicentre study

Abstract

In the context of a multicentre study on the use of technetium 99m hexakis-2-methoxyisobutylisonitrile (99mTc-Sestamibi), we evaluated the accuracy of the ventricular function assessed at rest by means of first-pass radionuclide angiocardiography acquired during the injection of the tracer for myocardial perfusion scintigraphy. The results were compared with first-pass studies performed using reference tracers sodium pertechnetate Tc 99m or technetium 99m diethylene triamine penta-acetic acid or with gated radionuclide angiocardiography. A total of 66 patients of the 105 enrolled in the study could be evaluated. The comparison of the first-pass studies was possible in 33 subjects with regard to the left ventricular ejection fraction, yielding r = 0.909 (P less than 10(-6)), and in 22 cases with regard to the right ventricular ejection fraction, yielding r = 0.712 (P less than 0.001). The comparison between the first-pass study using 99mTc-Sestamibi and the equilibrium gated radionuclide angiocardiography was possible for the left ventricular ejection fraction in 26 cases, with r = 0.937 (P less than 10(-6)), and for the right ventricular ejection fraction in 15 subjects, with r = 0.783 (P less than 0.001). In conclusion, the assessment of ventricular function performed by acquiring a first-pass radionuclide angiocardiograph during the injection of 99mTc-Sestamibi for perfusion myocardial scintigraphy can be considered reliable and accurate, when compared with the usually employed techniques. This result confirms the feasibility of a combined evaluation of perfusion and function at rest and during stress testing, which represents one of the most interesting advantages offered by the use of 99mTc-Sestamibi.

<b>Technetium-99m Tetrofosmin Myocardial Perfusion Single Photon Emission Computed Tomography in Syndrome X</b>

“…The LVEF was determined from this volume curve using the following formula: [(end-diastolic counts) -(end-systolic counts)] × 100% ÷ (end-diastolic counts). 22,23) Perfusion imaging began 90 minutes after injection of Tc-99m tetrofosmin. All studies were performed using an Elscint SPX Helix SPECT System, with an HPC-35 (lowenergy, general-purpose) collimator.…”

Correlation of Abnormal Response of Left Ventricular Ejection Fraction after Exercise and Left Ventricular Cavity-to-Myocardium Count Ratio of Technetium-99m-Tetrofosmin Single Photon Emission Computed Tomography in Patients with Coronary Artery Disease. A Preliminary Report.

“…The LVEF was determined from this volume curve using the following formula: [(end-diastolic counts) -(end-systolic counts)] × 100% ÷ (end-diastolic counts). [3][4][5] The exercise and resting C/M ratios were calculated according to the procedure proposed by Roberti, et al 7) Briefly, a 2 × 2 pixel rectangular ROI was drawn in the center of the left ventricular cavity on a midventricular short-axis slice. Thereafter, the number of total ROI counts was noted and the ROI was moved to the hottest area of the left ventricular wall for identification.…”

“…The advantages of technetium-99m (Tc-99m) labeled compounds over thallium-201 (Tl-201) for myocardial perfusion imaging include (a) the optimum features it has for single photon emission computed tomography (SPECT) 3,4) and (b) the possibility of simultaneously evaluating LVEF by collecting first-pass radionuclide ventriculography data during tracer injection. [3][4][5] In addition, recently, the value of a low cavity-to-myocardial count ratio (C/M ratio) on Tc-99m sestamibi myocardial perfusion SPECT for detecting patients with left ventricular dysfunction has been demonstrated.…”

“…[3][4][5] In addition, recently, the value of a low cavity-to-myocardial count ratio (C/M ratio) on Tc-99m sestamibi myocardial perfusion SPECT for detecting patients with left ventricular dysfunction has been demonstrated. 6,7) Tc-99m tetrofosmin wich competes with Tc-99m sestamibi, has been used as a newer myocardial image agent and has been considered to have mechanisms similar to those of Tc-99m sestamibi.…”

Exercise and Rest Technetium-99m-Tetrofosmin Lung Uptake

“…[9][10][11] In addition, lung uptake in Tc-99m MIBI myocardial perfusion imaging has been proven to predict left ventricular dysfunction. [12][13][14] Tc-99m tetrofosmin competing with Tl-201 and Tc-99m MIBI has been used as a new radiopharmaceutical for myocardial imaging.…”